POS0735 PREDICTORS OF RELAPSE IN PATIENTS WITH GIANT CELL ARTERITIS: RESULTS FROM A MULTICENTER, PROSPECTIVE PATIENT COHORT
Authors: C. Tsalapaki, A. Lazarini, K. Boki, A. Iliopoulos, P. Sfikakis, M. Tektonidou, A. Georgountzos, P. V. Voulgari, E. Theotikos, C. Papagoras, T. Dimitroulas, E. Kataxaki, G. Vosvotekas, D. Boumpas, D. Vassilopoulos
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Despite significant advances in the diagnosis and therapy of giant cell arteritis (GCA), relapses during the disease course are common. The exact predictors for their occurrence at diagnosis or during the disease course have not been defined. <h3>Objectives</h3> To evaluate the frequency and predictors of relapses in a real-life GCA cohort. <h3>Methods</h3> Data were derived from an ongoing, multicenter, prospective cohort study of patients with GCA. Patients were evaluated at baseline and approximately 2 years later. Data regarding their demographics, clinical characteristics, treatment patterns, co-morbidities and relapses were retrospectively and prospectively collected and analyzed. Predictors of relapse were examined by logistic regression analyses. <h3>Results</h3> At the 1st cross-sectional evaluation, 254 patients with GCA were included; 68% were women with a mean age of 72.3 years at diagnosis and a mean disease duration of 2 years. Diagnosis had been established by temporal artery biopsy in 67% (n=171) and by ultrasound of temporal arteries in 21% (n=53) of patients. At the 2nd evaluation (median follow-up: 2.02 years), data were available for 199 patients (78%). All patients had been treated initially with glucocorticoids (GCs, mean prednisolone dose = 40 mg/day) and during the disease course additionally with non-biologic (39%, n=59) and/or biologic (16%, n=25) agents. At the 2nd evaluation time point, 73% of patients were still on therapy with GCs (60%) and/or GC-sparing agents (29%: non-biologics: 16%, biologics: 13%). During the prospective follow-up phase of 2 years, 27% (n=43) of patients had at least one disease relapse. Relapsing patients had shorter disease duration at 1st evaluation (1.4 <i>vs.</i> 4 years, p=0.015), more frequent large vessel involvement at diagnosis (21% <i>vs.</i> 8%, p=0.019) and cardiovascular events (CDV) during follow-up (14% <i>vs.</i> 4.2%, p=0.032), and had received a higher GC daily dose at diagnosis (mean 46.2 <i>vs.</i> 39.9 mg, p=0.01) compared to the non-relapsing ones. By multivariable logistic regression analysis, large vessel involvement at diagnosis [odds ratio (OR) (95% confidence intervals) = 4.22 (1.14, 15.58)], a cardiovascular event (CVD) during follow-up [OR = 4.60 (1.11, 19.13)] and a higher GC daily dose at diagnosis [OR = 1.04 (1.00, 1.08)] were associated with disease relapses. <h3>Conclusion</h3> In this large, real-life, long -term GCA cohort, despite continued treatment with GCs and/or GC-sparing agents, relapses occurred in 27% of patients. Factors associated with relapses included large vessel involvement and high GC dose at diagnosis as well as cardiovascular events during follow up. These are novel findings that could be useful in the design of the appropriate monitoring and therapeutic strategies in these patients. <h3>Acknowledgements</h3> Supported in part by the Greek Rheumatology Society and Professional Association of Rheumatologists (ERE-EPERE) and the Special Account for Research Grants (S.A.R.G.), National and Kapodistrian University of Athens, Athens, Greece (DV #12085, 12086). <h3>Disclosure of Interests</h3> None Declared.